Rheumatoid arthritis affects women in their child-bearing years and many will face the issue of pregnancy and RA management at some point. Here are11 considerations for those managing RA patients who wish to become pregnant.

The American College of Rheumatology established a guidelines committee that consisted of both patients, rheumatologists and maternal-fetal health experts. After a a systematic review of the medical literature regarding contraception, assisted reproductive technology, fertility preservation, hormone replacement therapy pregnancy, lactation, and medication use in rheumatic disease patients, they published 12 good practice statements and 131 recommendations for reproductive health care in RMD patients.

Hydroxychloroquine (HCQ) helped reduce recurrent maternal autoantibody-mediated congenital heart block (CHB) in fetuses, an open-label study suggested.

Dr Jack Cush reviews the news, journal articles and takes a few Back Talk questions this week:

Extraintestinal manifestations (EIMs) frequently accompany inflammatory bowel disease, often augmenting morbidity and mortality are associated with disease activity and may increase the need for surgery or treatment escalation.  A recent review in GUT details the treatment options for patients with EIM.

Since patients with SLE have longer life expectancies in the modern era, they may be at elevated risk for HCQ adverse events, including maculopathy and cardiomyopathy. Therefore, Peter M. Izmirly, MD, of New York University School of Medicine in New York City, and colleagues assessed whether older SLE patients could safely discontinue HCQ.

ARD has published a report showing that patients with early rheumatoid arthritis have cardiovascular disease that is modifiable with conventional and aggressive therapy and that it did not matter if first line DMARD therapy was with a tumour necrosis factor-inhibitor or methotrexate.

Annals of Internal Medicine has published a population based study showing that the use of (short term) corticosteroid bursts were associated with GI bleeding, sepsis, and heart failure, often occurring within the first month of steroid therapy. 

Lancet Infectious Disease has reviewed the epidemiology, causes, clinical features, and current treatment for the multisystem inflammatory syndrome in children (MIS-C) and adolescents associated with COVID-19, noting severe organ damage can occur pediatric COVID-19 patients who are severely ill.&

Dr. Jack Cush reviews the news and journal articles from the past week. Of mice and men in cartilage, the efficacy of JAK inhibitors in patients who are having skin problems, nrAxSpa has its own diagnostic code, metformin, talking about Back Talk, plus so much more.